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. 2025 Mar 19;20(3):e0319946.
doi: 10.1371/journal.pone.0319946. eCollection 2025.

Long-term outcomes of biodegradable versus 2nd generation durable polymer drug-eluting stents in PCI: Protocol for a systematic review and meta-analysis

Rosa J Thuemmler  1   2 , Trisha Choudhary  2   3 , Yong Hui Tan  2   4 , Maria-Bianca Andrei  2   5 , Haipeng Liu  2   6 , Niraj S Kumar  2   7
Affiliations

Long-term outcomes of biodegradable versus 2nd generation durable polymer drug-eluting stents in PCI: Protocol for a systematic review and meta-analysis

Rosa J Thuemmler et al. PLoS One. .

Abstract

Background: More than 3 million individuals globally experience STEMI each year, with percutaneous coronary intervention (PCI) as the preferred revascularization method. While second-generation Drug Eluting Stents (DES) reduce restenosis compared to bare-metal stents, complications such as neoatherosclerosis and stent thrombosis remain. Second-generation stents, including durable polymer (DP-DES) and biodegradable polymer (BP-DES), aim to improve outcomes, though guidelines do not specify a preference. Given mixed results from prior studies and new long-term data, we aim to perform a systematic review and meta-analysis comparing long-term outcomes of DP-DES vs. BP-DES following PCI.

Methods: This protocol has been developed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. MEDLINE, Embase, and Scopus databases will be searched for eligible observational and interventional studies from inception up to 5th of October 2024. Screening (title/abstract and full text), data extraction, risk of bias assessment, and quality of evidence assessment will be conducted by two independent reviewers. A random-effects model will be used to meta-analyse outcomes.

Discussion: DES have greatly advanced PCI for STEMI. However, long-term stent thrombosis remains an issue due to chronic inflammation and impaired healing from the stent's polymer coating. To overcome this, BP-DES were introduced to dissolve their coating within 2-9 months. However, whether BP-DES offers superior long-term outcomes compared to second-generation DP-DES remains uncertain. While previous meta-analyses have shown similar outcomes, recent studies suggest BP-DES may offer better long-term results. This review will compare long-term outcomes (≥5 years) of BP-DES vs. DP-DES, providing important insights to inform clinical practice. Systematic review registration: PROSPERO (CRD42024592579).

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Conflict of interest statement

NSK received funding from the British Heart Foundation for a 4-year PhD.

Figures

Fig 1
Fig 1. Overview of study design.
See this image and copyright information in PMC

References

    1. Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, et al.. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2023;23(1):206. doi: 10.1186/s12872-023-03231-w - DOI - PMC - PubMed
    1. Byrne RA, Rossello X, Coughlan JJ, et al.. 2023 ESC guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2023;44:3720–826. - PubMed
    1. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al.. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation. 2004;110(5):588–636. doi: 10.1161/01.CIR.0000134791.68010.FA - DOI - PubMed
    1. Chhabra L, Zain MA, Siddiqui WJ. Angioplasty. BMJ. 2023;321:122.
    1. Giustino G, Colombo A, Camaj A, et al.. Coronary In-Stent Restenosis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2022;80:348–72. - PubMed

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